World Cancer Day 2015

Today, 4th February, is World Cancer Day.  Taking place under the tagline ‘Not beyond us’, World Cancer Day 2015 will take a positive and proactive approach to the fight against cancer, highlighting that solutions do exist across the continuum of cancer, and that they are within our reach.

The campaign will explore how we can implement what we already know in the areas of prevention, early detection, treatment and care, and in turn, open up to the exciting prospect that we can impact the global cancer burden – for the better.

World Cancer Day is a unique opportunity to raise awareness that there is much that can be done at an individual, community and governmental level, to harness and mobilise these solutions and catalyse positive change. By moving forward together we have the potential to show: Cancer. It is not beyond us.

The Dividing Line in Cancer Care for 2030

A new report published by Macmillan Cancer Support discusses what cancer care might look like in 2030.

The report says that “Recent years have seen remarkable improvements and innovations in the treatment of cancer and in the delivery of care. However, these co-exist alongside significant inequalities that, at their most extreme, dictate the prospects of survival.

The reality of pioneering innovation in cancer care is that we focus so much on the future that we may neglect to understand the present – where the efficacy of any future innovations in treatment and care is being influenced by a set of conditions in ‘the now’. These conditions may set in motion inequalities that will entrench a dividing line between those who will benefit and those who never will. This dividing line will be ever more important in 2030 when the UK population affected by cancer will double to four million”.

Precise and equitable: Spreading the language of cancer care in 2030

The Institute of Global Health Innovation’s Director, Professor the Lord Ara Darzi and Policy Fellow Ryan Callahan contributed to this report, focusing on the group of technologies known as ‘precision cancer care’.

They suggest that there are at least three potential traps that could mean the promise of precision cancer care fails to extend across the “dividing line”.  These failures would mean precision cancer care will not improve existing inequalities and may even contribute to their worsening:

  1. Failing to address core drivers of existing inequality in cancer care
  2. Failing to mitigate the effects of the inverse equity law
  3. Failing to mitigate the effects of the inverse care law

Amid the enthusiasm for a ‘revolution’ in the way we deliver cancer care, they believe a note of caution is necessary from the standpoint of equity, with greater consideration for the historical precedent in oncology and healthcare more broadly, in which innovation has, unfortunately, been applied unevenly and contributed to widening gaps in outcome. They hope that this discussion helps influence the way we speak about the future of precision cancer care, with success measured not just in the number of genomes we sequence or number of therapies we introduce, but also by the share of the population speaking a common language and reaping the benefits from precision cancer care.

While they believe that a greater focus on precision cancer care may entrench or exacerbate inequalities, they reiterate that its potential value merits concerted action to mitigate these risks. They hope that precision cancer care will advance as rapidly and equitably as possible. To that end, they have made five policy recommendations which they believe would begin to address these problems:

  1. Prioritise those aspects of precision medicine that will address current inequalities – improve access to risk stratification for improved prevention.
  2. Educate the public about new innovations in precision cancer care so that they will be prepared to look for and ask about them.
  3. Automate processing and provide decision support where appropriate to enhance more clinicians’ ability to participate in precision cancer care.
  4. Make disproportionate investments in precision cancer care in deprived areas; for example, locate specialised diagnostic centres here, and monitor outcomes relative to investment levels.
  5. Form knowledge affiliations between concentrated centres of precision cancer care expertise and secondary facilities to extend the benefits of precision cancer care more widely.

Further reading

Read the full Macmillan report entitled ‘The Dividing Line in Cancer Care for 2030: Exploring the effect of inequalities on four million lives’ here

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